Healthcare Provider Details
I. General information
NPI: 1710150495
Provider Name (Legal Business Name): MOSHE E HIRTH MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2008
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6646 ATLANTIC AVE STE 100
DELRAY BEACH FL
33446-1627
US
IV. Provider business mailing address
6646 ATLANTIC AVE STE 100
DELRAY BEACH FL
33446-1627
US
V. Phone/Fax
- Phone: 561-638-9533
- Fax: 561-638-7760
- Phone: 561-638-9533
- Fax: 561-638-7760
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | ME64286 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
MOSHE
HIRTH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-638-9533